Raphael (I don’t use patients real names, so I thought this would be a fun one) came to the office recently to have his monthly Vivitrol injection. Vivitrol is the trade name for a long acting formulation of naltrexone, which is a pure opiate antagonist or blocker.

Raph completed a rapid opioid detox with The Coleman Institute several months ago. Prior to that he used heroin and assorted pills for almost a decade. He has a small, but growing construction company. He used to work for someone but had to create his own business because of a felony charge for possession some years ago.

He told me that a couple of weeks before this office visit he was looking for something inside the toolbox on the back of his truck when he found a small bag of heroin. Raph said it was like time was suspended; he held the bag in his hand, staring at it as if an alien had started growing up out of his palm. He felt shock, disbelief and — interestingly — most strongly, he says he felt fierce anger.

The Brain on Drugs

Repetitively using opioids changes the brain’s ability to function. If Raphael had found his little bag of heroin when he was still actively using, he very likely wouldn’t have hesitated to use it. The brain of the opioid user desires to repeat the behavior again and again to get the same good feelings.

Without opioids the human brain coordinates the activity of billions of neurons throughout the body, but opioids totally override this ability and functioning is altered. When a person repeatedly consumes opioids, the brain is imbalanced, but is always trying to right itself. As Raph and most of our other patients could tell us, they felt as though they functioned incredibly well on their opioids.

And to a certain extent, this is true. The brain rearranges itself to try to accommodate any situation it’s in. But sadly, when the brain is able to adapt to the constant presence of opioids, opioid dependence is established. This means that without the drugs, withdrawal is inevitable.


Healing The Brain

After completing the rapid opioid detox at the Coleman Institute, Raph’s brain began the healing process. Our protocols help a great deal with getting through the initial intense withdrawal. Symptoms such as anxiety, chills, diarrhea, insomnia, muscle spasms and insomnia are largely reduced or eliminated.

And although Raphael is doing well and his Post-Acute Withdrawal (PAWS) symptoms (which are pretty standard after being on opioids for such a long time) are tolerable, he readily admits that having naltrexone on board when he found the heroin may have saved him from relapse.

His brain will likely be vulnerable for several months. This is why we strongly encourage our patients to commit to at least a year of naltrexone therapy using either implants or injections, coupled with counseling that further helps the brain learn new patterns of reacting to life’s inevitable stresses and surprises…like an argument with your spouse, a disagreement with your boss or finding a bag of heroin in your toolbox.

Please call us at 877-773-3869 if you have any questions about our rapid opioid detox. We are here to help.

Joan Shepherd, FNP



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